Individual
SIA KRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6010 SW SHATTUCK RD, PORTLAND, OR 97221-1043
(503) 246-8811
Mailing address
12425 NW BARNES RD APT 43, PORTLAND, OR 97229-6091
(971) 563-2629
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
391631
OR
Other
Enumeration date
09/28/2017
Last updated
09/28/2017
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